THEY came from the forgotten communities of America who maintain their traditions with dignity in the mountains and tropical forests, on the banks of rivers and in small towns and villages. Always attached to family, the land, the prodigious corn, neighborhood friends, they barely grasped the distance, the homesickness, and equally how far away Cuba was for them.

In early 1999, the conditions were created for the start of a new project in Havana. The campus of the former naval school became the Latin American School of Medicine with 1,993 students from 18 nations, representing almost the entire continent. The first to arrive came from the Central American region devastated by recent hurricanes.

At the current time, there are 8,447 young people studying on the five-year degree course. Those in the third to fifth years are found in the 21 medicine faculties throughout the country, and linked to hospitals in the provinces where they are located.

Some of them spoke with Granma International about the experiences that have changed their lives. In August 2005, they will return to their countries as doctors. The first graduates will number around 1,380 from 19 different countries, including one U.S. citizen, and represent the first crop from the Latin American School.

At 18 years of age, Ledesma Liset Arita was one of the first students. She left a tiny village in Santa Barbara province in Honduras where a river of thermal waters flows from the mountainside, and is the pride of the local population.

She had never been separated from her parents before but says that she came here determined to study for her degree. "Cuba is famous for the quality of its teaching; I couldn’t let homesickness overwhelm me."

Just like the rest of the 5th year Honduran students, since the third year of the course she has been located at the faculty within the Calixto García Training Hospital in Vedado. Here they receive classes, tour the wards with the doctors, and do shifts at the emergency room with hospital staff.

"The teaching methods are very good; they encourage students to study more through frequent evaluations, seminars, tests and workshops. Another thing that has impressed me, because I’ve felt it throughout the course, is the attention you receive from the teachers, the desire they have to teach."

Beyond the teaching methods, the development of these young people also extends to their personalities. "We have learned to live alongside people from other cultures, to understand them, to be more independent and responsible," comments Ledesma Liset.

Tomás Bardales sums up his five years as "a wonderful period". "They have helped us to grow as people; we are at an age when we are starting to form our own ideals, our personalities and for this reason I believe that the best thing that could have happened to us as students is to have come to Cuba, one of the most prestigious countries in terms of medicine in America and the world."

The largest delegations – from Honduras and Guatemala – after Nicaragua, were located in various faculties in training hospitals in the capital, from the third year onward. The rest are placed throughout the island.

Around 200 Guatemalans have reached the fifth year, including 24-year-old Guillermo Barrios. Leaving Cuba will once again test his emotional fortitude. "It’s not going to be the same when we go back: the lives of the friends we had before will have changed; they’ll have got married and be working. Of course, our stay here has helped us to see life from another point of view, and I hope that we can better place ourselves in our societies. I’m really going to miss not just one, but many families who have supported me during this time, also the friends I’ve made, the society, the way people are, their friendliness and hospitality."

For both him and Tomás, their gratitude is infinite. "They have given us what no other country has: somewhere to live, food to eat, books, classes, everything."

In Cienfuegos, some 200 kilometers from Havana, Chilean Magdalena Brito thinks the same. She has made lots of friends and, from the third year of the course, has acquired experience from the practical placement and specialists in the city’s two main hospitals. Although Magdalena feels somewhat saddened when the moment comes to talk about her departure next year, her conviction will instill a sense of hope inside her when she returns to her village in Chile’s cold and forgotten southern region. She tells us that she will be one of the few doctors available for her people.

Juan Carrizo has a long medical and teaching career behind him – some 30 years – five of which have been spent at the Latin American School of Medicine, a place "where it’s not just the students who have increased their knowledge."

Referring to the students set to graduate within the next 12 months, the dean affirms that: "If they have grown, then we have grown alongside them because this is an institution in which one can learn about human beings, of experiences – sometimes unimaginable – that are occurring in the world where these young people come from. Although you might have read things, or listened, it’s not the same when you learn to feel those experiences together with the students, to understand the experiences and problems they face in their countries of origin. Sometimes their behavior at a given moment reflects the burdens of their lives, their education or absence of training.

"They have had an appropriate preparation; one that has seen them grow in terms of the profession’s human and ethical values, with a spirit of solidarity, because they are trained within the doctrine of our own doctors, and when they finish their studies, they are going to fulfill the aims of this program. The vast majority of them have a tremendous commitment to helping their communities, to going back to their places of origin," adds Carrizo.

He commented that with respect to recognizing the qualifications, progress has been made with certain Latin American universities in terms of bilateral and governmental agreements, principally with Venezuela, Ecuador, Bolivia, Guatemala and Honduras.

"It’s a subject that should interest all governments because it represents a mass of well-prepared young people, a human resource that will provide much-needed transformations in the field of healthcare. It is an investment in human capital, donated by our country."

Nelson Aícaíre is Uruguayan. He is always seen with the small flask and metal straw for the mate he has drunk since he was 12 years old. He’s now 23. He studied medicine in his country but was unable to continue because of economic difficulties. He found out about the scholarship through the Uruguayan University Students Union and, fulfilling the required requisites, he is now in the second year at the Latin American School.

"The academic level of the program is excellent. Comparing it to medical programs in other places, this one devotes more time to actual practice, to being closer to the patient and focuses not just on the biomedical side but also on the social part. In the first year, we spent five weeks on Integral General Medicine in clinics, where we learnt basic nursing methods and interviews, and now we are on the introduction to Clinical Medicine, where we’re learning how to give patients physical examinations," he told me.

"What do you think you’ll do when you graduate?" I asked.

"I grew up in an orphanage. I want to work for the children that live in those places, because I know that the medical attention they receive is not the best. After that, I’d like to help the people who live on the outskirts of Montevideo, we’re talking about people who only eat every other day, the poorest areas."

According to Nelson, the public healthcare that exists is suffering a total decline. These people could never ever pay for private healthcare. The costs are around $200-300 a month plus the price of medicines.

Sartoma Sefa-Boakye is of African origin. Her parents left Ghana more than 30 years ago for the United States, where she was born. At the university in Los Angeles, California, she studied the pre-medical course but it was difficult to continue. "In order to study medicine, you have to pay between $25-30,000 per year," she explained.

Sartoma came here two years ago. Her father had read an article about the school in The Los Angeles Times when former president Jimmy Carter toured the faculty during his stay in Cuba. After that, Sartoma got in touch with the Reverend Lucius Walker, head of the Pastors for Peace organization, who runs the committee that selects potential U.S. scholarship students for ELAM.

"Here, there’s a lot more emphasis on practice in the teaching program. You feel a lot more support, the professors have a lot more clinical knowledge because they know how to diagnose without the use of equipment and instruments. In countries such as the United States, the specialists are more dependent on computer systems to provide a diagnosis."

The young woman explains that 80% of the inhabitants in her neighborhood in the city of Los Angeles don’t have medical insurance. Sartoma will be there for them when she returns.

As all the students say, ELAM has become the center of their lives. For Joel José Caraballo from Sucre state in Venezuela, medicine was his preferred choice of career. His family lives in a rural community where the majority of people are from indigenous backgrounds (guaraos and cariñas, that is to say, mixed race communities). He explained that there are no doctors there and those that are closest charge the population an arm and a leg.

Joel believes that "the ELAM project is extremely important for the situation in Latin America at this time. It is contributing a tremendous solution to the lack of doctors and poor health in the region."

Recuadro

Mayra Sánchez Martín is a professor of embryology and founder of the school. "This is a new and unique experience. You can have students from up to 22 countries altogether in one classroom."

"Those who have difficulties, with either adaptation or learning, receive personal attention from the department’s psychology teachers for student orientation and development," explained Wally Parraño, methodologist, professor and medical psychology consultant.